Presumed Urinary Tract Infection in Patients Admitted with COVID-19: Are We Treating Too Much?

Bibliographic Details
Title: Presumed Urinary Tract Infection in Patients Admitted with COVID-19: Are We Treating Too Much?
Authors: Johan Van Laethem, Stephanie C. M. Wuyts, Jan Pierreux, Lucie Seyler, Gil Verschelden, Thibault Depondt, Annelies Meuwissen, Patrick Lacor, Denis Piérard, Sabine D. Allard
Source: Antibiotics, Vol 10, Iss 12, p 1493 (2021)
Publisher Information: MDPI AG, 2021.
Publication Year: 2021
Collection: LCC:Therapeutics. Pharmacology
Subject Terms: antimicrobial stewardship, antibiotics, bacterial respiratory tract infection, coinfection, COVID-19, superinfection, Therapeutics. Pharmacology, RM1-950
More Details: Despite the low rates of bacterial co-/superinfections in COVID-19 patients, antimicrobial drug use has been liberal since the start of the COVID-19 pandemic. Due to the low specificity of markers of bacterial co-/superinfection in the COVID-19 setting, overdiagnosis and antimicrobial overprescription have become widespread. A quantitative and qualitative evaluation of urinary tract infection (UTI) diagnoses and antimicrobial drug prescriptions for UTI diagnoses was performed in patients admitted to the COVID-19 ward of a university hospital between 17 March and 2 November 2020. A team of infectious disease specialists performed an appropriateness evaluation for every diagnosis of UTI and every antimicrobial drug prescription covering a UTI. A driver analysis was performed to identify factors increasing the odds of UTI (over)diagnosis. A total of 622 patients were included. UTI was present in 13% of included admissions, and in 12%, antimicrobials were initiated for a UTI diagnosis (0.71 daily defined doses (DDDs)/admission; 22% were scored as ‘appropriate’). An evaluation of UTI diagnoses by ID specialists revealed that of the 79 UTI diagnoses, 61% were classified as probable overdiagnosis related to the COVID-19 hospitalization. The following factors were associated with UTI overdiagnosis: physicians who are unfamiliar working in an internal medicine ward, urinary incontinence, mechanical ventilation and female sex. Antimicrobial stewardship teams should focus on diagnostic stewardship of UTIs, as UTI overdiagnosis seems to be highly prevalent in admitted COVID-19 patients.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2079-6382
Relation: https://www.mdpi.com/2079-6382/10/12/1493; https://doaj.org/toc/2079-6382
DOI: 10.3390/antibiotics10121493
Access URL: https://doaj.org/article/bf915b06620b451eb5df8a875b38d186
Accession Number: edsdoj.bf915b06620b451eb5df8a875b38d186
Database: Directory of Open Access Journals
More Details
ISSN:20796382
DOI:10.3390/antibiotics10121493
Published in:Antibiotics
Language:English